Ardabil University of Medical Sciences
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Inverse Relationship Between Helicobacter pylori cagG Pathogenicity Island and Risk of Gastric Ulcer
No full textHelicobacter pylori is a spiral-shaped gram-negative bacterium that infects the human gastric mucosa and is associated with the development of gastrointestinal diseases such as chronic atrophic gastritis, peptic ulceration, and gastric adenocarcinoma. About 10-15% of H.pylori infections have been reported to lead to peptic ulceration, and H.pylori is responsible for 70-85% of gastric ulcers and 90-95% of duodenal ulcers [1]. The cag pathogenicity island
(cagPAI)of H. pylori contains some 32 different genes, encoding a type IV secretion system (T4SS). The presence of cagPAI is associated with the development of peptic ulcerations [2,3]. The cagPAI locus has a length of about 40 kb and includes 2 sections: the cagI region containing 16 genes and the cagII region containing 14 genes. The two cagA and cagE genes from the cagI region, and the cagT and cagM genes, as markers of the cagII region, play an important role in gastroduodenal diseases, such as peptic ulceration, gastric cancer [4-6] ,duodenal ulceration and gastric ulceration [9, 10]. CagL and CagH are two other proteins
from cagPAI that are essential for transfer and injection of CagA into host epithelial cells as well as formation of T4SS pili [2]. In our hands, the cagL, but not the cagH gene is strongly associated with the risk of peptic ulceration [2], and elsewhere this genotype is associated with the risk of duodenal ulcer [11]. The cagG and orf17 genes are two other genes from cagPAI. The cagG gene is located upstream of the cagA gene and encodes the CagG protein, which plays a role in colonization and inflammation. Although orf17 has no significant relationship with gastric cancer, it is related to the risk of peptic ulceration [2]. Accordingly, pyloric ulcers-related risk factors should be considered separately for duodenal and gastric ulceration. Therefore, we hypothesised an associations betweenf H. pylori cagPAI genotypes (i.e. cagL, orf17, cagG, and cagH) with the risk of either gastric or duodenal ulceration
Echinococcus contamination ratio and its related risk factors in Moghan plain, northwest of Iran
Get PDFBackground and Objectives: Alveolar and cystic echinococcosis (AE and CE) are caused by the larval stages of Echinococcus multilocularis and Echinococcus granulosus, respectively. This study aimed to determine the prevalence of human AE and CE diseases among the tribes, livestock breeders, and farmers in Moghan plain, northwest of Iran. Materials and Methods: Screening of hydatid cystic fluid antigen (HCF-Ag) was done by enzyme-linked immunosorbent (ELISA) kit. Briefly, HCF-Ag was collected, and the prevalence of the disease was evaluated using specific antigens for AE and CE (Ag-5, Ag-B, and Em2+) and questionnaires. A total of 2453 serum samples were randomly collected from normal populations of five different areas of Moghan plain. The serology was evaluated using ELISA kit and specific antigens for AE and CE. Results: Of the 2453 serum samples, 36 were positive for AE (1.46%). The infection rate was higher in males than females (1.94% vs. 0.94%). The age group of 4–19 years had the lowest and 40–59 years had the highest infection rate (0.2% vs. 2.5%). Among CE-positive serum samples, 178 samples were positive to Ag-5 (7.3%) and 167 samples were positive to Ag-B (6.8%). Conclusion: Our findings showed that the highest infection rates were in the Borran and Eivazlou regions, and the lowest level of infection was for Parsabad area of Moghan plain. In areas with higher contamination, the risk factors associated with CE and AE were the water quality, the method of washing vegetables, and occupational and hydatid disease knowledge of the inhabitants
Gluteal Hydatid Cyst: A Case Report
Get PDFHydatid cyst caused by Echinococcus granulosus usually involves lung and liver but can appear in other organs. We report a 29-yr-old woman presented to Fatemi Hospital, Ardabil, Iran in 2017 with progressive painful swelling of
the left gluteus which in imaging showed hydatid cyst. The cyst was successfully en blocked and the patient was discharged on albendazole treatment with no recurrence in the symptoms during the first week, first and second months after surgery follow-up and in the final visit at third months. In the endemic regions, the possibility of hydatid cysts should be considered in differential diagnosis of any cystic mass
Evaluation of ventilator-associated pneumonia risk factors in patients admitted to neonatal intensive care unit (NICU) in Ardabil Bou Ali Hospital
Get PDFBackground and objective : Ventilator-associated pneumonia is defined as inflammation of the lung parenchyma due to infectious agent activity 48 hours after the start of mechanical ventilation in patients who have tracheal intubation and did not have pneumonia at the time of intervention. Due to the lack of local information available, the high mortality rate and the results of this study can help improve child care standards under mechanical ventilation in intensive care units. The aim of this study was to evaluate the risk factors of ventilator-associated pneumonia in patients admitted to neonatal intensive care unit (NICU) in Bu-Ali Ardabil hospital. The aim of this study was to evaluate the risk factors of ventilator-associated pneumonia in patients admitted to neonatal intensive care unit (NICU) in Bu-Ali Ardabil hospital.
Methods : This is a cross-sectional, analytical descriptive and prospective study. The sampling method was simple random. Patients were randomly selected for three months and all cases were included in the study until the sample size was reached According to Cochran's sample size determination formula based on community size (N = 250), Inclusion criteria include infants admitted to the NICU ward of bu-ali Hospital who are connected to a ventilator for any reason. Exclusion criteria include neonatal death before pneumonia and neonatal mechanical ventilation.
Results: In this study, 100 neonates admitted to NICU ward of Ardabil Bou Ali Hospital, 61 of them were boys and the rest were girls. Out of 100 neonates, 48 had ventilator-associated pneumonia. There was a significant relationship between gender, surfactant, steroid medication, enteral nutrition,re-intubation, blood transfusion and mechanical ventilation time with pneumonia. There were no vasoactive drugs and NGT between the incidence of pneumonia and GA
Conclusion : Regarding the relationship between the incidence of ventilator-associated pneumonia , steroid and surfactant intake, blood transfusion, enteral nutrition, re-intubation and intubation time, it is recommended to reduce the above factors to reduce the morbidity and mortality caused by ventilator-associated pneumonia
Evaluating the efficacy of douloxetine and gabapentin in pain reduction in patients with knee osteoarthritis
No full textINTRODUCTION:
Knee osteoarthritis (OA) is a common form of arthritis in elders which can lead to reduced daily activity and quality of life. It is important to administer a proper treatment with high efficacy and low side effects. In this study, we evaluated the efficacy of duloxetine and gabapentin in patients with moderate to severe knee OA.
METHOD:
In this randomized clinical trial, 150 patients with moderate to severe knee OA were randomly allocated to receive duloxetine 30 mg (n = 50), gabapentin 300 mg (n = 50), or acetaminophen 1000 mg (n = 50) all twice a day for 12 weeks. Pain severity using visual analogue scale (VAS) and functional status using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were measured before, 2 weeks, 1 month, and 3 months after intervention.
RESULTS:
WOMAC total and its subscale score were significantly lower in duloxetine compared to gabapentin in 2 weeks and 1 months after intervention, with no significant difference at the end of the third month. Both gabapentin and duloxetine groups had significantly more reduction in pain VAS and WOMAC and its subscales compared to acetaminophen group, with no significant difference between groups.
CONCLUSIONS:
Both gabapentin and duloxetine have similar and acceptable effects in pain reduction and improvement of functional status in patients with knee OA at the end of the third month's treatment. Duloxetine effects begin from the first weeks, while gabapentin effects begin gradually with the best at the end of the third month.
KEY POINTS:
Medical treatment is used for releiving pain in knee osteoarthritis. • Gabapentin and duloxetine are both effective in reducing pain in knee osteoarthritis
Inverse association of Helicobacter pylori cagPAI genotypes with risk of cardia and non‐cardia gastric adenocarcinoma
Get PDFIran is a high‐risk country for cardia gastric adenocarcinoma (CGA) in Central Asia, with an incidence rate five times the average global rate, and shows a high infection rate for Helicobacter pylori (69%). The aim was to examine the associations of multiple H. pylori cagPAI genotypes (ie cagH, cagL, cagG, and orf17) with the risk of
CGA, non‐CGA, and different histological types of GA in Iran. A large number of H. pylori strains (N = 336) were successfully cultured and genotyped. Histopathological
evaluations were performed. The analysis showed an inverse association between the cagH+ genotype and the risk of CGA and intestinal‐type gastric adenocarcinoma (IGA) (adjusted ORs; 0.312 and 0.283, respectively), where the controls were nontumors. The orf17+ genotype decreased the risk of non‐CGA and diffuse‐type gastric adenocarcinoma (DGA)(adjusted ORs; 0.310 and 0.356, respectively). When the controls were those with nonatrophic gastritis, the cagG+ genotype was negatively associated with the risk of CGA, non‐CGA, IGA, and DGA (adjusted ORs; 0.324, 0.366, 0.306, and 0.303, respectively). We did not find such a significant association for the cagL+ genotype in multiple logistic regression analysis. Combination of the vacA c2 and cagPAI genotypes further decreased the risk estimates for GAs.
This study showed the reverse association of H. pylori cagPAI genotypes—cagH+ and cagG+—with the risk of CGA in male patients aged ≥ 55 in Iran. Presence of the vacA c2 genotype in combination with cagPAI genotypes showed strong inverse associations with the risk of CGA and non‐CGA. These findings may reveal a coordinated relationship between the vacA c2 and cagPAI genotypes
Computational design of a chimeric epitope-based vaccine to protect against staphylococcus aurus infections
No full textRecently, Staphylococcus aureus has become increasingly resistant to antibiotics such as methicillin and vancomycin. Accordingly, developing an effective prevention strategy against S. aureus is a necessity. In the current study, to protect against S. aureus, an epitope-based vaccine was constructed using diverse bioinformatics servers. The investigations were done on five antigens as vaccine candidates, which are supposed to promote various cellular and humoral immune responses. In this research, four cell-surface antigens including manganese transport protein C, iron surface determinant A and B, and clumping factor A as well as one secreted toxin named α-toxin were selected as the candidate antigens. Additionally, PorB of Neisseria meningitidis, a Toll-Like Receptor (TLR) 2 agonist, was employed as the adjuvant in the designed construct. Epitope identification was done for each antigen. Then, the adjuvant and the high-ranked epitopes were linked to each other through proper linkers. Moreover, to get a 3D model of the designed construct, homology modeling, refinement, and validation were performed. Finally, docking and molecular dynamics (MD) simulation studies revealed a strong vaccine-TLR2 interaction during the simulation time. Therefore, the designed vaccine construct can be regarded as a promising vaccine candidate to tackle staphylococcal infections by generating humoral and cellular immune responses
Effect of ketofol in reducing cough caused by fentanyl in patients undergoing general anesthesia
Get PDFFentanyl is now widely used for anesthetic and pain relief. Fentanyl with the 80-fold antinociceptive effect of morphine was introduced in the 1960s as an intravenous anesthetic in medicine. The incidence of fentanyl-related cough is reported to be about 80-28% and is an undesirable side effect of anesthesia. Its main application is as an analgesic and sedative preanesthetic in the operating room. The aim of this study was to evaluate the effect of ketofol on couched induced fentanyl in patients undergoing general anesthesia. The is a randomized, double-blind clinical trial that has been done on 124 patients candidate for general anesthesia in age range 16-60 years which hospitalized in Fatemi and Imam hospitals in Ardabil city in year 2018. Checklist included demographic and clinical data collected for all patients. The first group received ketamine 2 cc, the second group received propofol 2 cc (10 mg), the third group received ketofol 2 cc(propofol 10 mg + ketamine 10 mg 1: 1), and the fourth group received normal saline 2 cc by orally. Then fentanyl (2 mu g / kg) was administered to each of the 4 groups. Coughing, severity and time of onset of it were recorded in time intervals per second in each of the four groups. Finally, all the data entered the statistical analysis program and analyzed by statistical methods in SPSS version 20. In this study, couch rate was 22.6%, 32.3%, 6.5% and 61.3% in ketamine, Propofol, ketofol and control group respectively. The highest cough delay was observed in the recipients of ketofol and propofol, and the highest premature cough was observed in the control group. Also, none of the prescribed drugs did significantly change the blood pressure, heart rate, and MAP in the control group. It was observed that ketofol, ketamine and propofol significantly reduced the cough rate compared with the control group. The results of this study showed that ketofol had the most fentanyl-induced cough suppressant compared to placebo and propofol, and it can be used a good medication for patients
Effect of cell-free fetal DNA on spontaneous preterm labor
No full textInflammatory phenomenon, including cell-free fetal DNA (cffDNA), is one of the variouscauses of preterm delivery. Always, there is a trend in the prediction and prevention
of preterm labor. Herein, the aim of this study is to assess the value of cffDNA levels in serum of pregnant women for prediction of spontaneous preterm labor. A case–control study with nonrandomized convenience sampling was conducted. One hundred women qualifying for the study were enrolled. The participants were divided into two groups
of healthy nulliparous pregnant women (n = 50) and nulliparous pregnant women experiencing preterm labor (n = 50). Then, venous blood was sampled from each participant and its plasma was separated and analyzed. The mean age of women in the experimental group was 22.90 years with the standard deviation of 4.04, while in the control group these two values were 23.78 and 4.37, respectively. In the experimental group, 29 patients (58%), and in the control group, 27 patients (54%) had cffDNA. The mean of the counted DNA in the experimental group was 2080/03 with the standard deviation of 909/792 while the same values for the control group were 1183/26 and 620/720, in the same order. The statistical analysis revealed that this difference was
meaningful at P = 0.001. Furthermore, in the experimental group, cffDNA increased with increase in the age and the difference was meaningful. Finally, increasing pregnancy
age in the experimental group led to an increase in the number of cffDNA (P = 0.001). The results of this study indicated that the cumulative frequency of preterm labor for
women with positive cffDNA was significantly higher. High levels of cells’ DNA in the serum of pregnant mothers increase the risk of spontaneous preterm labor. These
observations may have implications for preterm labor
PET/MRI: current status and future perspectives
No full textHybrid imaging is specified as the combination of two or more imaging technologies into a single, new form of imaging. Typically, this new form is synergistic that is, more powerful than the sum of its parts. Although some hybrid imaging modalities may be used purely to depict anatomy, the most exciting characteristic of hybrid imaging is its potential to show molecular processes in vivo within their larger anatomic context. PET/MRI is a first-of-its-kind imaging technology approved by the FDA in 2014. This combined technology is used for the diagnosis, staging and treatment of a variety of conditions, including cancer, neurological, oncological and musculoskeletal diseases. PET/MRI provides high-quality images while reducing patient exposure to radiation. PET/MRI may increase diagnostic accuracy over the single modalities. In this approach we focus on clinical applications of PET/MRI: current status and future perspectives